Abstract Background and Objective: Post-traumatic amnesia (PTA) is an early significant stage of recovery from traumatic brain injury (TBI). Current prospective PTA scales do not assess the full range of PTA symptomatology. This study conducted a novel integrated assessment of cognition and behaviour during PTA. Method: Twenty-four moderate-to-severe TBI participants in PTA and 23 TBI controls emerged from PTA were matched for age, gender, and years of education. All completed PTA measures (Galveston Orientation and Amnesia Test: GOAT, Westmead Post-traumatic Amnesia Scale: WPTAS), a cognitive battery; and behaviour ratings scored by 2 independent raters (informant and staff). Results: Significantly poorer performance was found during PTA for attention, processing speed, delayed verbal free recall and recognition, and visual learning. A large effect size was found for category fluency only. Behaviour ratings were significantly higher during PTA. Five behaviours were rated as high frequency (>50%) by both raters: Inattention, Impulsivity, Sleep Disturbance, Daytime Arousal, and Self-Monitoring. Prospective PTA measures produced significantly different duration estimates from 2 days (GOAT vs. WPTAS 1st day) to 9 days (WPTAS 1st day vs. 3-day). The WPTAS correlated most highly with processing speed and language tasks; whilst the GOAT correlated most highly with language and executive control of verbal memory. Conclusion: New prospective measures are needed that integrate core cognitive and behavioural features are brief, easy to administer, and capable of measuring emergence. The term PTA is a misnomer that requires revision to better accommodate the clinical syndrome.
背景与目的:创伤后遗忘症(PTA)是创伤性脑损伤(TBI)恢复的早期重要阶段。目前的前瞻性PTA量表不能评估PTA症状的全部范围。本研究对PTA期间的认知和行为进行了新颖的综合评估。方法:24名中重度TBI的PTA参与者和23名从PTA中产生的TBI对照组在年龄、性别和受教育年限上相匹配。所有完成的PTA测试(Galveston Orientation and Amnesia Test: GOAT, Westmead创伤后失忆量表:WPTAS)，认知测试;行为评分由两名独立评分者(告密者和工作人员)评分。结果:PTA在注意力、加工速度、言语自由回忆和识别延迟以及视觉学习方面的表现明显较差。仅在类别流畅性中发现了较大的效应量。在PTA期间，行为评分明显更高。五种行为被两个评分者评为高频率(>50%):注意力不集中、冲动、睡眠障碍、白天觉醒和自我监控。前瞻性PTA测量产生了显著不同的持续时间估计，从2天(山羊与WPTAS第1天)到9天(WPTAS第1天与3天)。WPTAS与处理速度和语言任务相关度最高;而GOAT与语言和言语记忆的执行控制关系最为密切。结论:需要新的前瞻性测量方法，结合核心认知和行为特征，简短，易于管理，并能够测量突发性。术语PTA是一个用词不当，需要修订，以更好地适应临床综合征。
{"title":"More than amnesia: prospective cohort study of an integrated novel assessment of the cognitive and behavioural features of PTA","authors":"M. Hennessy, Lorryn Delle Baite, L. Marshman","doi":"10.1017/BrImp.2021.2","DOIUrl":"https://doi.org/10.1017/BrImp.2021.2","url":null,"abstract":"Abstract Background and Objective: Post-traumatic amnesia (PTA) is an early significant stage of recovery from traumatic brain injury (TBI). Current prospective PTA scales do not assess the full range of PTA symptomatology. This study conducted a novel integrated assessment of cognition and behaviour during PTA. Method: Twenty-four moderate-to-severe TBI participants in PTA and 23 TBI controls emerged from PTA were matched for age, gender, and years of education. All completed PTA measures (Galveston Orientation and Amnesia Test: GOAT, Westmead Post-traumatic Amnesia Scale: WPTAS), a cognitive battery; and behaviour ratings scored by 2 independent raters (informant and staff). Results: Significantly poorer performance was found during PTA for attention, processing speed, delayed verbal free recall and recognition, and visual learning. A large effect size was found for category fluency only. Behaviour ratings were significantly higher during PTA. Five behaviours were rated as high frequency (>50%) by both raters: Inattention, Impulsivity, Sleep Disturbance, Daytime Arousal, and Self-Monitoring. Prospective PTA measures produced significantly different duration estimates from 2 days (GOAT vs. WPTAS 1st day) to 9 days (WPTAS 1st day vs. 3-day). The WPTAS correlated most highly with processing speed and language tasks; whilst the GOAT correlated most highly with language and executive control of verbal memory. Conclusion: New prospective measures are needed that integrate core cognitive and behavioural features are brief, easy to administer, and capable of measuring emergence. The term PTA is a misnomer that requires revision to better accommodate the clinical syndrome.","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"10 1","pages":"294 - 311"},"PeriodicalIF":0.8,"publicationDate":"2021-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87773130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sarah Buys, L. Gustafsson, Hannah L Gullo, R. Grimley, M. Summers, A. Campbell
Abstract Background: The Montreal Cognitive Assessment (MoCA) is routinely used during the early assessment of people after stroke to indicate cognitive effects and inform clinical decision-making. Aim: The purpose of this study was to examine the relationship between cognition in the first week post-stroke and personal and instrumental activities of daily skills at 1 month and 3 months post-stroke. Method: A prospective cohort study consecutively recruited people admitted to the acute stroke ward. Acute cognitive status was measured using the MoCA within 1 week post-stroke onset. Functional outcomes were measured using the Functional Independence Measure (FIM) and the Australian Modified Lawton’s Instrumental Activities of Daily Living Scale (Lawton’s) at 1 month and 3 months post-stroke. Results: Fifty participants with predominantly mild stroke (n = 47) and mean age of 69.8 achieved a mean MoCA score of 23.1. Controlling for age, the MoCA was associated with the overall FIM score at 1 month (P = 0.02). It was nearing significance for the Lawton’s at 1 month (P = 0.06) but was not associated with either outcome at 3 months. A score of less than 23 on the MoCA was indicative of lower scores on both outcomes. Conclusions: A low MoCA score within 1 week of stroke may indicate need for support or rehabilitation due to early impacts on personal activities of daily living, but is not associated with poor functional outcomes at 3 months.
{"title":"Cognition in the first week after stroke: how does it relate to personal and instrumental activities of daily living at follow-up?","authors":"Sarah Buys, L. Gustafsson, Hannah L Gullo, R. Grimley, M. Summers, A. Campbell","doi":"10.1017/BrImp.2021.3","DOIUrl":"https://doi.org/10.1017/BrImp.2021.3","url":null,"abstract":"Abstract Background: The Montreal Cognitive Assessment (MoCA) is routinely used during the early assessment of people after stroke to indicate cognitive effects and inform clinical decision-making. Aim: The purpose of this study was to examine the relationship between cognition in the first week post-stroke and personal and instrumental activities of daily skills at 1 month and 3 months post-stroke. Method: A prospective cohort study consecutively recruited people admitted to the acute stroke ward. Acute cognitive status was measured using the MoCA within 1 week post-stroke onset. Functional outcomes were measured using the Functional Independence Measure (FIM) and the Australian Modified Lawton’s Instrumental Activities of Daily Living Scale (Lawton’s) at 1 month and 3 months post-stroke. Results: Fifty participants with predominantly mild stroke (n = 47) and mean age of 69.8 achieved a mean MoCA score of 23.1. Controlling for age, the MoCA was associated with the overall FIM score at 1 month (P = 0.02). It was nearing significance for the Lawton’s at 1 month (P = 0.06) but was not associated with either outcome at 3 months. A score of less than 23 on the MoCA was indicative of lower scores on both outcomes. Conclusions: A low MoCA score within 1 week of stroke may indicate need for support or rehabilitation due to early impacts on personal activities of daily living, but is not associated with poor functional outcomes at 3 months.","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"14 15 1","pages":"185 - 195"},"PeriodicalIF":0.8,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80668574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The clinical profile of Aboriginal and Torres Strait Islander adults admitted to hospital with neurological injury is not well documented. Understanding these profiles may enable health professionals to provide more culturally responsive health care for this patient group. This study aimed to report the clinical profile of Aboriginal and Torres Strait Islander adults admitted to a regional Queensland hospital due to stroke or traumatic brain injury (TBI). A 2-year retrospective medical record review of Aboriginal and Torres Strait Islander adults (≥18 years) admitted to a regional Queensland hospital with principal diagnoses of stroke or TBI. There were 132 Aboriginal and Torres Strait Islander adult stroke (51.5%) or TBI (48.5%) admissions. The mean ages were 56.7 years for stroke and 42.7 years for TBI. The majority of patients (83.3%) were of Aboriginal descent with others identifying as Torres Strait Islander only, or both Aboriginal and Torres Strait Islander. Patients were from 26 diverse home locations across northern Australia, primarily Outer Regional or Remote/Very Remote geographical locations. All patients’ language backgrounds were documented as English only. Over 90% of stroke and 50% of TBI patients presented with medical co-morbidities. Patients had diverse geographical locations and cultural backgrounds, with many likely impacted by dislocation from home and country, as well as potential delays in receiving treatment. Despite this diversity, English was documented in patients’ medical records as their only language. The majority of patients also presented with multiple medical co-morbidities. Health professionals should consider these factors to ensure patients receive optimum and culturally responsive health care.
{"title":"Clinical profile of Aboriginal and Torres Strait Islander adults with stroke and traumatic brain injury at a regional Australian hospital: a retrospective chart audit","authors":"Frances Cochrane, S. Siyambalapitiya, P. Cornwell","doi":"10.1017/BrImp.2021.1","DOIUrl":"https://doi.org/10.1017/BrImp.2021.1","url":null,"abstract":"\u0000 \u0000 \u0000 The clinical profile of Aboriginal and Torres Strait Islander adults admitted to hospital with neurological injury is not well documented. Understanding these profiles may enable health professionals to provide more culturally responsive health care for this patient group. This study aimed to report the clinical profile of Aboriginal and Torres Strait Islander adults admitted to a regional Queensland hospital due to stroke or traumatic brain injury (TBI).\u0000 \u0000 \u0000 \u0000 A 2-year retrospective medical record review of Aboriginal and Torres Strait Islander adults (≥18 years) admitted to a regional Queensland hospital with principal diagnoses of stroke or TBI.\u0000 \u0000 \u0000 \u0000 There were 132 Aboriginal and Torres Strait Islander adult stroke (51.5%) or TBI (48.5%) admissions. The mean ages were 56.7 years for stroke and 42.7 years for TBI. The majority of patients (83.3%) were of Aboriginal descent with others identifying as Torres Strait Islander only, or both Aboriginal and Torres Strait Islander. Patients were from 26 diverse home locations across northern Australia, primarily Outer Regional or Remote/Very Remote geographical locations. All patients’ language backgrounds were documented as English only. Over 90% of stroke and 50% of TBI patients presented with medical co-morbidities.\u0000 \u0000 \u0000 \u0000 Patients had diverse geographical locations and cultural backgrounds, with many likely impacted by dislocation from home and country, as well as potential delays in receiving treatment. Despite this diversity, English was documented in patients’ medical records as their only language. The majority of patients also presented with multiple medical co-morbidities. Health professionals should consider these factors to ensure patients receive optimum and culturally responsive health care.\u0000","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"40 1","pages":"281 - 293"},"PeriodicalIF":0.8,"publicationDate":"2021-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72681603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Background/Objectives: Medication management is challenging for persons with Alzheimer’s disease (AD) and their caregivers. Electronic medication management devices (eMMDs) are specifically designed to support this task. However, theory-driven interventions for eMMD training with this population are rarely described. This study aimed to develop and assess the appropriateness of an intervention protocol to train persons with early-stage AD how to use an eMMD. Methods: Interviews with three categories of participants [persons with early-stage AD (n = 3), caregivers (n = 3), and clinicians (n = 3)] were conducted to understand medication management needs, perceived usefulness of an eMMD, and to explore training strategies. Subsequently, this knowledge was integrated in an intervention protocol which was validated with the three clinicians. A content analysis led to iterative modifications to maximize the acceptability and coherence of the intervention protocol in a homecare context. Results: The final intervention protocol specifies the expertise required to provide the training intervention and the target population, followed by an extensive presentation of eMMD features. Specific learning strategies tailored to the cognitive profile of persons with AD with step-by-step instructions for clinicians are included. Finally, it presents theoretical information on cognitive impairment in AD and how eMMDs can support them. Conclusions: This intervention protocol with its theoretical and pragmatic foundation is an important starting point to enable persons with early-stage AD to become active users of eMMDs. Next steps should evaluate the immediate and long-term impacts of its implementation on medication management in the daily lives of persons with AD and their caregivers.
{"title":"Training persons with early-stage Alzheimer’s disease how to use an electronic medication management device: development of an intervention protocol","authors":"M. Tellier, Claudine Auger, L. Demers","doi":"10.1017/BRIMP.2020.25","DOIUrl":"https://doi.org/10.1017/BRIMP.2020.25","url":null,"abstract":"Abstract Background/Objectives: Medication management is challenging for persons with Alzheimer’s disease (AD) and their caregivers. Electronic medication management devices (eMMDs) are specifically designed to support this task. However, theory-driven interventions for eMMD training with this population are rarely described. This study aimed to develop and assess the appropriateness of an intervention protocol to train persons with early-stage AD how to use an eMMD. Methods: Interviews with three categories of participants [persons with early-stage AD (n = 3), caregivers (n = 3), and clinicians (n = 3)] were conducted to understand medication management needs, perceived usefulness of an eMMD, and to explore training strategies. Subsequently, this knowledge was integrated in an intervention protocol which was validated with the three clinicians. A content analysis led to iterative modifications to maximize the acceptability and coherence of the intervention protocol in a homecare context. Results: The final intervention protocol specifies the expertise required to provide the training intervention and the target population, followed by an extensive presentation of eMMD features. Specific learning strategies tailored to the cognitive profile of persons with AD with step-by-step instructions for clinicians are included. Finally, it presents theoretical information on cognitive impairment in AD and how eMMDs can support them. Conclusions: This intervention protocol with its theoretical and pragmatic foundation is an important starting point to enable persons with early-stage AD to become active users of eMMDs. Next steps should evaluate the immediate and long-term impacts of its implementation on medication management in the daily lives of persons with AD and their caregivers.","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"13 1","pages":"329 - 342"},"PeriodicalIF":0.8,"publicationDate":"2021-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84912066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Barbra Zupan, Leah S Dunn, S. Hackney, Bahtiyorhon Shamshidinova
Abstract The purpose of this review was to explore how vocal affect recognition deficits impact the psychosocial functioning of people with moderate to severe traumatic brain injury (TBI). A systematic review following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines was conducted, whereby six databases were searched, with additional hand searching of key journals also completed. The search identified 1847 records after duplicates were removed, and 1749 were excluded through title and abstract screening. After full text screening of 65 peer-reviewed articles published between January 1999 and August 2019, only five met inclusion criteria. The methodological quality of selected studies was assessed using the Mixed Methods Appraisal Tool (MMAT) Version 2018 with a fair level of agreement reached. A narrative synthesis of the results was completed, exploring vocal affect recognition and psychosocial functioning of people with moderate to severe TBI, including aspects of social cognition (i.e., empathy; Theory of Mind) and social behaviour. Results of the review were limited by a paucity of research in this area, a lack of high-level evidence, and wide variation in the outcome measures used. More rigorous study designs are required to establish more conclusive evidence regarding the degree and direction of the association between vocal affect recognition and aspects of psychosocial functioning. This review is registered with Prospero.
{"title":"The relationship between vocal affect recognition and psychosocial functioning for people with moderate to severe traumatic brain injury: a systematic review","authors":"Barbra Zupan, Leah S Dunn, S. Hackney, Bahtiyorhon Shamshidinova","doi":"10.1017/BrImp.2020.24","DOIUrl":"https://doi.org/10.1017/BrImp.2020.24","url":null,"abstract":"Abstract The purpose of this review was to explore how vocal affect recognition deficits impact the psychosocial functioning of people with moderate to severe traumatic brain injury (TBI). A systematic review following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines was conducted, whereby six databases were searched, with additional hand searching of key journals also completed. The search identified 1847 records after duplicates were removed, and 1749 were excluded through title and abstract screening. After full text screening of 65 peer-reviewed articles published between January 1999 and August 2019, only five met inclusion criteria. The methodological quality of selected studies was assessed using the Mixed Methods Appraisal Tool (MMAT) Version 2018 with a fair level of agreement reached. A narrative synthesis of the results was completed, exploring vocal affect recognition and psychosocial functioning of people with moderate to severe TBI, including aspects of social cognition (i.e., empathy; Theory of Mind) and social behaviour. Results of the review were limited by a paucity of research in this area, a lack of high-level evidence, and wide variation in the outcome measures used. More rigorous study designs are required to establish more conclusive evidence regarding the degree and direction of the association between vocal affect recognition and aspects of psychosocial functioning. This review is registered with Prospero.","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"193 1","pages":"260 - 280"},"PeriodicalIF":0.8,"publicationDate":"2021-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82556192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Alharbi, S. Aloyuni, F. Kashoo, M. Waly, Harpreet Singh, Mehrunnisha Ahmad
Infantile hemiplegia due to brain injury is associated with poor attention span, which critically affects the learning and acquisition of new skills, especially among children with left-sided infantile hemiplegia (LSIH). This study aimed to improve the selective visual attention (SVA) of children with LSIH through transcranial direct current stimulation (tDCS).A total of 15 children participated in this randomized, double-blinded, pilot study; of them, 10 experienced LSIH, and the remaining 5 were healthy age-matched controls. All the children performed the Computerized Stroop Color-Word Test (CSCWT) at baseline, during the 5th and 10th treatment sessions, and at follow-up. The experimental (n = 5) and control groups (n = 5) received tDCS, while the sham group (n = 5) received placebo tDCS. All three groups received cognitive training on alternate days, for 3 weeks, with the aim to improve SVA.Two-way repeated measures analysis of variance (ANOVA) showed a statistically significant change in the mean scores of CSCWT between time points (baseline, 5th and 10th sessions, and follow-up) within-subject factor, group (experimental, sham) between-subject factor and interaction (time points X group) (p < 0.005). Furthermore, a one-way repeated measures ANOVA showed significant differences between time point (p < 0.005) for the experimental and control group but not the sham group.These pilot results suggest that future research should be conducted with adequate samples to enable conclusions to be drawn.
{"title":"Does transcranial direct current stimulation affect selective visual attention in children with left-sided infantile hemiplegia? A randomized, controlled pilot study","authors":"R. Alharbi, S. Aloyuni, F. Kashoo, M. Waly, Harpreet Singh, Mehrunnisha Ahmad","doi":"10.1017/brimp.2020.20","DOIUrl":"https://doi.org/10.1017/brimp.2020.20","url":null,"abstract":"Infantile hemiplegia due to brain injury is associated with poor attention span, which critically affects the learning and acquisition of new skills, especially among children with left-sided infantile hemiplegia (LSIH). This study aimed to improve the selective visual attention (SVA) of children with LSIH through transcranial direct current stimulation (tDCS).A total of 15 children participated in this randomized, double-blinded, pilot study; of them, 10 experienced LSIH, and the remaining 5 were healthy age-matched controls. All the children performed the Computerized Stroop Color-Word Test (CSCWT) at baseline, during the 5th and 10th treatment sessions, and at follow-up. The experimental (n = 5) and control groups (n = 5) received tDCS, while the sham group (n = 5) received placebo tDCS. All three groups received cognitive training on alternate days, for 3 weeks, with the aim to improve SVA.Two-way repeated measures analysis of variance (ANOVA) showed a statistically significant change in the mean scores of CSCWT between time points (baseline, 5th and 10th sessions, and follow-up) within-subject factor, group (experimental, sham) between-subject factor and interaction (time points X group) (p < 0.005). Furthermore, a one-way repeated measures ANOVA showed significant differences between time point (p < 0.005) for the experimental and control group but not the sham group.These pilot results suggest that future research should be conducted with adequate samples to enable conclusions to be drawn.","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"14 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2020-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83032561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To review the effects of whole body vibration for patients with Parkinson’s disease.Randomized clinical trials comparing whole body vibration with no vibration or conventional physical therapy for patients with Parkinson’s disease were searched up to July 31, 2019.Seven studies with 196 patients were included for quantitative analysis. No significant difference was found between groups in motor score of unified Parkinson’s disease rating scale (UPDRS-III) (WMD [weighted mean difference] = −1.75, 95% CI, −5.40 to 1.90, I2 = 45.8%), functional reach test (SMD [standardized mean difference] = 0.21, 95% CI, −0.29 to 0.71; I2 = 0%), and other balance tests (including Berg balance test and Tinetti score) (SMD = 0.39, 95% CI, −0.01 to 0.80; I2 = 0%). No statistical difference was detected in walking velocity as well (WMD = −0.05, 95% CI, −0.17 to 0.06; I2 = 0%). In contrast, the pooled analysis from four studies on the Time Up and Go test showed favorable results for whole body vibration (WMD = −1.59, 95% CI, −2.90 to −0.28, I2 = 0%).Whole body vibration may not be beneficial over placebo or conventional physical therapy in overall motor function, balance, and walking velocity in patients with Parkinson’s disease. However, it might have positive effects on sit to stand transitions or turning.
{"title":"Effects of whole-body vibration on motor function in patients with Parkinson’s disease: a systematic review and meta-analysis","authors":"Chuan He, Caixia Su, Wentong Zhang, Qi Wan","doi":"10.1017/brimp.2020.21","DOIUrl":"https://doi.org/10.1017/brimp.2020.21","url":null,"abstract":"To review the effects of whole body vibration for patients with Parkinson’s disease.Randomized clinical trials comparing whole body vibration with no vibration or conventional physical therapy for patients with Parkinson’s disease were searched up to July 31, 2019.Seven studies with 196 patients were included for quantitative analysis. No significant difference was found between groups in motor score of unified Parkinson’s disease rating scale (UPDRS-III) (WMD [weighted mean difference] = −1.75, 95% CI, −5.40 to 1.90, I2 = 45.8%), functional reach test (SMD [standardized mean difference] = 0.21, 95% CI, −0.29 to 0.71; I2 = 0%), and other balance tests (including Berg balance test and Tinetti score) (SMD = 0.39, 95% CI, −0.01 to 0.80; I2 = 0%). No statistical difference was detected in walking velocity as well (WMD = −0.05, 95% CI, −0.17 to 0.06; I2 = 0%). In contrast, the pooled analysis from four studies on the Time Up and Go test showed favorable results for whole body vibration (WMD = −1.59, 95% CI, −2.90 to −0.28, I2 = 0%).Whole body vibration may not be beneficial over placebo or conventional physical therapy in overall motor function, balance, and walking velocity in patients with Parkinson’s disease. However, it might have positive effects on sit to stand transitions or turning.","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"41 1","pages":"1-12"},"PeriodicalIF":0.8,"publicationDate":"2020-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87348857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
There is a growing body of research demonstrating the effectiveness of interventions that might benefit people living with dementia and their families or caregivers. Yet, it can take years for research findings to be translated into practice for these benefits to be realised. Knowledge translation is a process or series of activities that aims to accelerate the uptake of research in practice. A commonly used definition suggests that it is a dynamic process that includes synthesis, dissemination, exchange and ethically sound application of knowledge to improve health, which occurs within a complex system of interactions between researchers and knowledge users (Canadian Institute of Health Research, n.d.). This special issue largely considers perspectives, experiences and outcomes concerning the application or implementation of a number of evidence-based non-pharmacological interventions for people living with dementia and their families or caregivers. This issue commences with a paper by Linton that explores the relationship between the health of caregivers and the health of the person they provide care for, who had either dementia or a brain injury. Although the paper does not have an implementation focus, it highlights some of the complexities surrounding this relationship – which is at the centre of many of the non-pharmacological interventions described in the rest of this issue. As is sometimes the case, there can be good evidence for the effectiveness of interventions in one population that may hold potential for use in a new population. However, prior to the intervention being implemented with the new population, it needs careful adaptation and testing. Scott et al. describe the adaptation of CarFreeMe – an effective driving cessation programme intervention originally designed for older adults – for people living with dementia and their caregivers. This is an important undertaking given the complexities of navigating this highly sensitive issue. Just because interventions have strong evidence, it does not mean that they will be translated into practice. An example of this is the well-tested Tailored Activity Program (TAP) developed in the USA by Gitlin et al. (2008). Despite at least five randomised controlled trials demonstrating its effectiveness, it is not in use in Australia. An important phase in preparing to implement any new practice is to understand key stakeholders’ perceptions about the intervention and its implementation. Hence, Bennett et al. explore the acceptability of TAP for people living with dementia, their caregivers and health professionals and their views about factors that might influence willingness to provide or receive this intervention, prior to its implementation in Australia. The next two studies in this issue (Culph et al., Rahja et al.) pertain to the implementation of the Care of Persons with Dementia in their Environments (COPE) programme, which originates from same stable (Gitlin, Winter, Dennis, Hodgson, &
越来越多的研究表明，干预措施的有效性可能使痴呆症患者及其家人或照顾者受益。然而，要将研究成果转化为实践，实现这些好处可能需要数年时间。知识翻译是一个过程或一系列活动，旨在加速研究成果在实践中的吸收。一个常用的定义表明，这是一个动态过程，包括知识的综合、传播、交流和合乎道德的应用，以改善健康，这发生在研究人员和知识使用者之间复杂的互动系统中(加拿大卫生研究所，无日期)。本期特刊在很大程度上考虑了一些针对痴呆症患者及其家人或照顾者的循证非药物干预措施的应用或实施的观点、经验和结果。这个问题始于林顿的一篇论文，该论文探讨了照顾者的健康与他们所照顾的人的健康之间的关系，这些人要么患有痴呆症，要么患有脑损伤。虽然这篇论文没有一个实施的重点，但它强调了围绕这种关系的一些复杂性——这是本期其余部分描述的许多非药物干预措施的中心。就像有时的情况一样，有充分的证据表明干预措施在一个人群中的有效性，可能在另一个人群中有使用的潜力。然而，在对新人群实施干预之前，需要仔细的适应和测试。Scott等人描述了CarFreeMe(一种最初为老年人设计的有效的戒烟计划干预)对痴呆症患者及其护理人员的适应性。鉴于处理这一高度敏感问题的复杂性，这是一项重要的工作。仅仅因为干预措施有强有力的证据，并不意味着它们将被转化为实践。这方面的一个例子是由Gitlin等人(2008年)在美国开发的经过良好测试的量身定制活动计划(TAP)。尽管至少有五项随机对照试验证明了它的有效性，但它并未在澳大利亚使用。准备实施任何新做法的一个重要阶段是了解关键利益相关者对干预措施及其实施的看法。因此，Bennett等人在澳大利亚实施TAP之前，探讨了痴呆症患者、他们的照顾者和卫生专业人员对TAP的可接受性，以及他们对可能影响提供或接受这种干预意愿的因素的看法。本期接下来的两项研究(Culph et al.， Rahja et al.)涉及痴呆症患者环境护理(COPE)计划的实施，该计划与TAP计划有着相同的起源(Gitlin, Winter, Dennis, Hodgson， & Hauck, 2010)。Rahja等人描述了痴呆症患者及其护理人员参与痴呆症治疗计划的经历和结果，该计划是调查澳大利亚COPE实施情况的研究计划的一部分。Culph等人的第二篇论文。
{"title":"Special issue: Knowledge translation and dementia care","authors":"S. Bennett","doi":"10.1017/BrImp.2020.17","DOIUrl":"https://doi.org/10.1017/BrImp.2020.17","url":null,"abstract":"There is a growing body of research demonstrating the effectiveness of interventions that might benefit people living with dementia and their families or caregivers. Yet, it can take years for research findings to be translated into practice for these benefits to be realised. Knowledge translation is a process or series of activities that aims to accelerate the uptake of research in practice. A commonly used definition suggests that it is a dynamic process that includes synthesis, dissemination, exchange and ethically sound application of knowledge to improve health, which occurs within a complex system of interactions between researchers and knowledge users (Canadian Institute of Health Research, n.d.). This special issue largely considers perspectives, experiences and outcomes concerning the application or implementation of a number of evidence-based non-pharmacological interventions for people living with dementia and their families or caregivers. This issue commences with a paper by Linton that explores the relationship between the health of caregivers and the health of the person they provide care for, who had either dementia or a brain injury. Although the paper does not have an implementation focus, it highlights some of the complexities surrounding this relationship – which is at the centre of many of the non-pharmacological interventions described in the rest of this issue. As is sometimes the case, there can be good evidence for the effectiveness of interventions in one population that may hold potential for use in a new population. However, prior to the intervention being implemented with the new population, it needs careful adaptation and testing. Scott et al. describe the adaptation of CarFreeMe – an effective driving cessation programme intervention originally designed for older adults – for people living with dementia and their caregivers. This is an important undertaking given the complexities of navigating this highly sensitive issue. Just because interventions have strong evidence, it does not mean that they will be translated into practice. An example of this is the well-tested Tailored Activity Program (TAP) developed in the USA by Gitlin et al. (2008). Despite at least five randomised controlled trials demonstrating its effectiveness, it is not in use in Australia. An important phase in preparing to implement any new practice is to understand key stakeholders’ perceptions about the intervention and its implementation. Hence, Bennett et al. explore the acceptability of TAP for people living with dementia, their caregivers and health professionals and their views about factors that might influence willingness to provide or receive this intervention, prior to its implementation in Australia. The next two studies in this issue (Culph et al., Rahja et al.) pertain to the implementation of the Care of Persons with Dementia in their Environments (COPE) programme, which originates from same stable (Gitlin, Winter, Dennis, Hodgson, & ","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"1 1","pages":"235 - 236"},"PeriodicalIF":0.8,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81042099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To satisfy requirements for continuing professional education, workforce demand for access to large-scale continuous professional education and micro-credential-style online courses is increasing. This study examined the Knowledge Translation (KT) outcomes for a short (2 h) online course about support at night for people living with dementia (Bedtime to Breakfast), delivered at a national scale by the Dementia Training Australia (DTA).A sample of the first cohort of course completers was re-contacted after 3 months to complete a KT follow-up feedback survey (n = 161). In addition to potential practice impacts in three domains (Conceptual, Instrumental, Persuasive), respondents rated the level of Perceived Improvement in Quality of Care (PIQOC), using a positively packed global rating scale.Overall, 93.8% of the respondents agreed that the course had made a difference to the support they had provided for people with dementia since the completion of the course. In addition to anticipated Conceptual impacts (e.g., change in knowledge), a range of Instrumental and Persuasive impacts were also reported, including workplace guidelines development and knowledge transfer to other staff. Tally counts for discrete KT outcomes were high (median 7/10) and explained 23% of the variance in PIQOC ratings.Online short courses delivered at a national scale are capable of supporting a range of translation-to-practice impacts, within the constraints of retrospective insight into personal practice change. Topics around self-assessed knowledge-to-practice and the value of positively packed rating scales for increasing variance in respondent feedback are discussed.
{"title":"Making sense of self-reported practice impacts after online dementia education: the example of Bedtime to Breakfast and Beyond","authors":"B. Goodenough, J. Watts, Sarah Bartlett","doi":"10.1017/BrImp.2020.19","DOIUrl":"https://doi.org/10.1017/BrImp.2020.19","url":null,"abstract":"To satisfy requirements for continuing professional education, workforce demand for access to large-scale continuous professional education and micro-credential-style online courses is increasing. This study examined the Knowledge Translation (KT) outcomes for a short (2 h) online course about support at night for people living with dementia (Bedtime to Breakfast), delivered at a national scale by the Dementia Training Australia (DTA).A sample of the first cohort of course completers was re-contacted after 3 months to complete a KT follow-up feedback survey (n = 161). In addition to potential practice impacts in three domains (Conceptual, Instrumental, Persuasive), respondents rated the level of Perceived Improvement in Quality of Care (PIQOC), using a positively packed global rating scale.Overall, 93.8% of the respondents agreed that the course had made a difference to the support they had provided for people with dementia since the completion of the course. In addition to anticipated Conceptual impacts (e.g., change in knowledge), a range of Instrumental and Persuasive impacts were also reported, including workplace guidelines development and knowledge transfer to other staff. Tally counts for discrete KT outcomes were high (median 7/10) and explained 23% of the variance in PIQOC ratings.Online short courses delivered at a national scale are capable of supporting a range of translation-to-practice impacts, within the constraints of retrospective insight into personal practice change. Topics around self-assessed knowledge-to-practice and the value of positively packed rating scales for increasing variance in respondent feedback are discussed.","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"49 1","pages":"299 - 313"},"PeriodicalIF":0.8,"publicationDate":"2020-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81875350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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